DHEC's Health and Environment Blog

Colorectal cancer deadly, but preventable

Colorectal cancer will claim the lives of an estimated 830 South Carolinians this year. Another 2,200 will be diagnosed with the disease.

According to the American Cancer Society’s “Cancer Facts and Figures 2016,” colorectal cancer is the second most common cancer in both men and women in the United States and South Carolina, with almost 49,000 deaths and 134,000 new cases occurring nationally. There are 1.2 million Americans living with colorectal cancer in the United States.

Despite those statistics, colorectal (or colon) cancer is a preventable disease — if it’s detected early, which is why it’s so critical for people 50 and older to be tested regularly. Only 64.2 percent of people 50 or older report having ever had a colorectal cancer screening test in South Carolina (S.C. Behavior Risk Factor Surveillance System 2012).

This month is National Colorectal Cancer Month, a time not only to be reminded of the damage this cancer can cause, but to be reminded of how early detection can help prevent the disease.

Catch colorectal cancer early

It’s important to screen for colon cancer because it often doesn’t reveal itself. The disease is a silent killer: Polyps and early stage colon cancer often cause no symptoms.

But the rate of new cases has been decreasing for most of the past two decades, a trend that has largely been attributed to increases in the use of colorectal cancer screening tests that allow for the detection and removal of colorectal polyps before they become cancerous (American Cancer Society, Cancer Facts and Figures 2014).

The U.S. Protective Services Task Force recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy or colonoscopy in adults beginning at age 50 and continuing until age 75. The colonoscopy is the most widely used.

Reducing the risk

According to the American Cancer Society, there are a number of factors that can increase the risk of getting colorectal cancer, including physical inactivity, overweight and obesity, smoking and alcohol use.

Family history and race also are factors.

People with a parent, sibling or child who has had colorectal cancer have two to three times the risk of developing the disease compared to individuals with no family history. If the relative was diagnosed at a young age or if there is more than one affected relative, the risk increases. About 20 percent of all colorectal cancer patients have a close relative who was diagnosed with the disease.

African-Americans are at a higher risk for the disease than other populations, according to studies. Starting at age 50, everyone should begin routine screening tests. Research shows that African-Americans are being diagnosed at a younger average age than other people. Therefore, some experts suggest that African-Americans should begin their screening at age 45.

There are ways to help reduce the risk of developing colorectal cancer, including:

getting screened regularly

adopting a physically active lifestyle

eating a healthy diet

limiting alcohol consumption

Screening more accessible to state employees

In South Carolina, the Public Employee Benefits Authority (PEBA) considered early detection to be so important that it made an intentional effort to increase colorectal cancer screening rates among state employees and their family members over age 50 — a group of approximately 118,000 enrollees. In order to find the right approach, PEBA, which administers retirement and insurance benefits for South Carolina public employers, employees and retirees, collaborated with the University of South Carolina Center for Colon Cancer Research, the American Cancer Society, the S.C. Cancer Alliance and the S.C. Department of Health and Environmental Control’s S.C. Central Cancer Registry (SCCCR).

Key data from the SCCCR was used to help produce critical materials and fact sheets for the PEBA Board of Directors to review. One of the recommendations among the materials was to remove all cost barriers for screening supported by data-driven statements using South Carolina’s incidence, mortality, stage distribution (particularly the percent of late-stage cases diagnosed annually), as well as the costs of treatment for advanced disease. The cost savings of screening versus treatment was demonstrated.

The board ultimately voted to remove cost barriers to screening for State Health Plan enrollees. Even though this screening was covered by the State Health Plan, deductibles, co-pays and out-of-pocket costs could add up to hundreds of dollars.

Effective January 2016, this colonoscopy benefit is offered at no cost to State Health Plan primary members at network providers. The State Health Plan has removed a patient’s out-of-pocket cost for diagnostic colonoscopies and routine screenings, including the pre-surgical consultation, the generic prep kit, the procedure itself and associated anesthesia. The state’s Standard and Savings plans follow the age recommendations set by the United States Preventive Services Task Force for routine colonoscopies.

The key refrain in the fight against colorectal cancer is simple and direct: Get screened regularly.